Botox is the first FDA-approved wrinkle-reducing injectable. It first appeared on the market 30 years ago. Twenty years later, the FDA approved a slightly different formulation for the same treatment. It’s called Xeomin.
Patients interested in smoothing out their wrinkles may wonder which of the two anti-wrinkle treatments is better. The following article explains the differences and similarities between Botox and Xeomin, helping you choose the right neurotoxin injectable for you.
Xeomin Vs. Botox: Definitions
What is Botox?
Botox is a brand name for botulinum toxin type A, a neurotoxin made by the bacterium Clostridium botulinum. The toxin can be deadly in large quantities, but the cosmetic industry uses small, safe doses to reduce the appearance of facial fine lines and wrinkles.
Botox consists of the main active ingredient, botulinum toxin, and additional proteins that naturally exist around the neurotoxin.
The generic name for Botox is onabotulinumtoxinA.
What is Xeomin?
Xeomin is a brand name for botulinum toxin type A. Like Botox, it is used in the cosmetic industry to reduce the appearance of facial fine lines and wrinkles.
Unlike Botox, Xeomin is stripped of all complexing proteins and contains only the active ingredient, botulinum toxin. It is also referred to as the “naked Botox”.
The generic name for Xeomin is incobotulinumtoxinA.
Xeomin Vs. Botox: Comparison Overview
The following table sums up the main differences between Xeomin and Botox, two of the four FDA-approved anti-wrinkle injectables.
| Botox | Xeomin | |
|---|---|---|
| Generic name | onabotulinumtoxinA | incobotulinumtoxinA |
| Composition | Botulinum toxin type A with complexing proteins | Botulinum toxin type A free of complexing proteins |
| Storage conditions | Refrigerated | Refrigerated or at room temperature |
| FDA-approved treatment areas | Glabellar (frown) lines between the eyebrows, wrinkles around the eyes (crow’s feet), lines on the forehead | Glabellar (frown) lines between the eyebrows |
| Recommended dosage | Up to 24 units per area | 20 units for glabellar lines |
| How long is the procedure? | Under 30 minutes | Under 30 minutes |
| Expected onset of effects | Up to two weeks | Up to one week |
| How long do effects last? | Up to six months | Up to six months |
| Potential side effects | Bruising, swelling, redness, headache, dry mouth, eye problems, neck pain Rare: Trouble breathing, speaking, swallowing, vision problems, loss of bladder control | Headache, bruising, swelling Rare: Allergic reactions, trouble breathing, speaking, swallowing, vision problems, loss of bladder control |
| Potential negative interaction with drugs | Muscle relaxants, sleeping aids, allergy medications, blood thinners, antibiotic injections | Muscle relaxants, sleeping aids, allergy medications, blood thinners, antibiotic injections |
| Medical insurance | Medical insurance doesn’t cover expenses for Botox anti-wrinkle treatments | Medical insurance doesn’t cover expenses for Xeomin anti-wrinkle treatments |
Treatment Areas
Botox and Xeomin are used at medical spas to reduce the appearance of dynamic facial wrinkles caused by repetitive muscle movements.
The neurotoxins are also FDA-approved for other conditions.
Botox Treatment Areas
The following are FDA-approved Botox treatment areas:
- Moderate to severe frown lines between the eyebrows
- Crow’s feet
- Lines on the forehead
- Overactive bladder symptoms
- Headache
- Cervical dystonia
- Limb spasticity
- Certain eye muscle problems (strabismus)
- Abnormal spasm of the eyelids (blepharospasm)
- Severe underarm sweating
Medspas and clinics may also use Botox "off-label" to treat:
- Chin wrinkles
- Sweaty palms
- Nose wrinkles (bunny lines)
- Wide nose
- Eyebrows
- Lines between the mouth and nose (lipstick lines)
- Lines around the mouth
- Neck wrinkles
- Nasolabial folds
- Under-eye lines
- Gummy smile
- Small upper lips (lip flip)
Xeomin Treatment Areas
Xeomin is FDA-approved to treat the following:
- Frown lines
- Upper limb spasticity
- Cervical dystonia
- Abnormal spasm of the eyelids (blepharospasm)
- Chronic sialorrhea
When administered in medical spas or clinics, Xeomin has been safely used to treat other wrinkles on the face, such as chin wrinkles and lines around the mouth.
Composition
The main difference between Botox and Xeomin lies in their composition.
Botox Composition
Botox consists of the main active ingredient, botulinum toxin type A, and complexing proteins that are naturally structured around it.
The Botox injectable also contains the inactive ingredients human albumin and sodium chloride.
Xeomin Composition
Xeomin consists of the main active ingredient, botulinum toxin type A, stripped of its complexing proteins.
Some studies show that this purified form of the botulinum toxin decreases the chance of the body developing immunoresistance to the treatment.
The Xeomin injectable also contains the inactive ingredients human albumin and sucrose.
Dosage
The necessary dosage of a botulinum toxin injectable depends on the area treated. The medical practitioner will determine the necessary dosage based on the patient’s needs and previous botulinum toxin treatments. The total number of units per treatment should not exceed 400 units for all treated areas combined.
Recommended Botox Dosage
The recommended Botox dosage for the most common treatment areas is:
- Glabellar lines—Total of 20 units divided into 5 injections of 4 units each, injected into 5 previously marked areas.
- Crow’s feet—Total of 24 units divided into 3 injections of 4 units each, injected into 3 previously marked areas on each side.
- Forehead wrinkles—Total of 20 units divided into 5 injections of 4 units each, injected into 5 previously marked areas.
Note: Check out our article to find out more details on how many units of Botox do you need for other areas as well.
Recommended Xeomin Dosage
The recommended Xeomin dosage for treating glabellar lines (the only approved usage) is a total of 20 units divided into 5 injections of 4 units each, injected into 5 previously marked areas.
Effectiveness
Botox and Xeomin provide similar results in terms of the longevity of effects.
Botox Effectiveness
The first signs of Botox effects usually appear up to two weeks after the procedure. For most patients, the effects of the Botox treatment last for three to four months. Some patients feel the effects for six months.
Xeomin Effectiveness
The first onset of Xeomin effects usually appears up to one week after the procedure. According to one study, the onset of effects happens slightly earlier with Xeomin than with Botox. For most patients, the effects of the Xeomin treatment last for three to four months. Some patients feel the effects for six months.
Side Effects and Risks
Side effects of Botox and Xeomin are similar. They are occasional and usually mild.
Botox Side Effects and Risks
Occasional side effects of Botox injections are:
- Pain, redness, swelling, bruising at the injection site
- Bumps
- Headache
- Neck pain
- Dry mouth
- Dry eyes or excessive tearing
- Droopy eyelids
Rare and severe side effects of Botox injections happen when the toxin spreads in the body, and they are:
- Difficulty breathing, speaking, and/or swallowing
- Muscle weakness
- Loss of bladder control
- Vision problems
Xeomin Side Effects and Risks
The most common side effect of Xeomin injections is a headache.
Rare and severe side effects of Xeomin injections include:
- Allergic reactions (itching, rash, dizziness, etc.)
- Difficulty breathing, speaking, and/or swallowing
- Muscle weakness
- Loss of bladder control
- Vision problems
Drug Interactions
Certain medications and supplements may cause side effects when used before or after a neurotoxin injection. During your cosmetic treatment consultation, tell your medical practitioner about all prescription and OTC drugs you are taking.
Medications that May Interact With Botox
The following medications may cause an adverse reaction if taken before or after a Botox treatment:
- Antibiotics taken by injection or inhalation
- Muscle relaxants
- Allergy or cold medicine
- Sleep medicine
- Other botulinum neurotoxin products
Medications that May Interact With Xeomin
The following medications may cause an adverse reaction if taken before or after a Xeomin treatment:
- Antibiotics taken by injection or inhalation
- Muscle relaxants
- Allergy or cold medicine
- Sleep medicine
- Other botulinum neurotoxin products
Costs
A neurotoxin injectable treatment cost depends on the area treated and how many units a medical practitioner recommends for the patient.
How Much Does Botox Cost?
At Vibrant Skin Bar, a unit of Botox costs $12. The total price for the procedure will depend on the areas treated and desired effects. For example, if you are treating glabellar lines and need 20 units, your Botox treatment’s total price will be $240.
How Much Does Xeomin Cost?
A unit of Xeomin typically costs about $10. It is slightly less expensive than Botox. The total cost of a Xeomin treatment depends on the area treated and desired effects. The average cost of a Xeomin treatment for glabellar lines is $200.
Botox vs. Xeomin: How to Choose?
Botox and Xeomin are very similar in terms of how they work, the results they provide, and longevity of effects.
Their main difference is in their composition. Xeomin’s lack of complexing proteins makes the injectable stable at room temperature, unlike Botox, which needs to be refrigerated. That makes Xeomin more convenient for storage. It may also minimize the chance of a body’s immune reaction to the treatment.
Botox is FDA-approved for glabellar lines, forehead lines, and crow’s feet. Xeomin is FDA-approved for glabellar lines. However, when administered in medical spas or clinics, both neurotoxin injectables are safe for use for other wrinkles on the face, such as chin wrinkles and lines around the mouth (smile lines). If you are interested in some alternatives, check out our article on the best botox alternatives for removing wrinkles.
Discuss your previous anti-wrinkle experiences, potential medical issues, and any medication you are taking with your chosen cosmetic practitioner. Tell them which facial areas you want to treat and what results you expect. Your cosmetic injectable administrator will then choose the appropriate neurotoxin treatment for you.
Next, learn about the similarities and differences between Botox and Jeuveau or discover the differences between Xeomin and Dysport.
